2016 Ham Lang Enterprises - Registration Form

Ham Lang Enterprises Registration Form 2016
Welcome! Thanks for registering for your 2016 Fundraising Sale! We are very excited about all the new, exciting things we have in store for you in 2016 to help grow your sale!
Group Name *
Group Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Is Your Billing Address the Same? *

Yes No
Billing Address (Enter Only If Different From Above)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Approx # of people on your sales team *
When Do You Plan on Kicking Off Your Sale?

Month Day Year
Online Marketplace.... In addition to your Traditional Citrus Sale you can sign up for a Free Custom Website. Your customers can place orders online for both Local Delivery and Mail Order items that can be direct shipped anywhere in the country. Our first year was a huge success and this year we will be expanding our product line to include seasonally themed and special occasion gifts... all designed to keep your customers coming back long after your Local Delivery Sale is over.
Do you want an Online Marketplace Website? *

Yes No I'm interested in More Info
SPRING SALE...

We offered Fresh Florida Strawberries, Oranges & Grapefruit in a few limited areas this past Spring and they were a huge hit! Pre-register now and we will go ahead and include your Spring Sales Flyers with your Fall Shipment.
Do you want to pre-register for a Spring Sale? *

Yes No I'm Interested In More Info
PRIMARY CONTACT INFO...

Please provide all the correct info for your contacts so we make sure we can get hold of you and your trucker can reach you.
Primary Contact *

First Name Last Name
Email *
Cell Phone *

Area Code Phone Number
Home Phone

Area Code Phone Number
Fax

Area Code Phone Number
Preferred Method of Contact

Email Phone Text
Best Time of Day to Contact
ALTERNATE CONTACT INFO...

We know you are dedicated but even you need a break every now and then. Please make sure we have an alternate contact on file in case your driver can't reach you.
Alternate Name

First Name Last Name
Alternate Cell Phone

Area Code Phone Number
Additional Contacts
Authorized Name *
Date *

Month Day Year
ADDITIONAL COMMENTS OR INFO REQUESTED....

Please let us know if you have any other questions or comments. We look forward to working with you again this year and making this your best sale ever!
Additional Requests/Comments
Should be Empty:

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Ham Lang Enterprises Registration Form 2016